Active NPI
P.W. Home Health Inc
- Home Health Agency
- Oakbrook Terrace, IL
National Provider Identifier
1417962812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- P.W. HOME HEALTH INC
- Practice address
- 17W662 Butterfield Rd Ste 306
Oakbrook Terrace, IL 60181-4006 - Phone
- (847) 565-4170
- Fax
- (847) 565-4173
- NPI assigned
- Jul 31, 2006
- Last updated
- Sep 6, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carmel A Ponte
- Title
- Administrator
- Phone
- (847) 565-4170
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
17W662 Butterfield Rd Ste 306
Oakbrook Terrace, IL 60181-4006
Mailing address
17W662 Butterfield Rd Ste 306
Oakbrook Terrace, IL 60181-4006
Phone (847) 565-4170
Other practice location 1
830 E. Higgins Road
Suite 115
Schaumburg, IL 60173-4702
Phone (847) 565-4170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050516000123 | IL | Part A Provider - Home Health Agency | 0244271740 | Practice locations: Oakbrook Terrace, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1417962812. Details of each certification follow.
Home health agency certification: CCN 147832
- Legal name
- PW HOME HEALTH INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 30, 2005
- Last certification
- Jul 9, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Aug 24, 2004 in IL
- Enrollment address
- 17W662 Butterfield Rd
Ste 306
Oakbrook Terrace, IL 60181-4006
Care Compare: Home health agency
Medicare Care Compare- Listed as
- P W Home Health, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Sep 30, 2005
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
17W662 Butterfield Rd
Ste 306
Oakbrook Terrace, IL 60181
Phone (630) 685-2902
830 E Higgins Rd
Ste 115
Schaumburg, IL 60173
Phone (847) 565-4170
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Carmel Ponte | Corporate Officer | May 31, 2017 | 50% |
| Corporate Director | May 31, 2017 | 50% | |
| W-2 Managing Employee | May 31, 2017 | 50% | |
| Jonathan Burgos | Corporate Officer | May 31, 2017 | 50% |
| Corporate Director | May 31, 2017 | 50% | |
| W-2 Managing Employee | May 31, 2017 | 50% | |
| Silver Care Group LLC | 5% Or Greater Direct Ownership Interest | Jun 30, 2016 | 100% |
| 5% Or Greater Indirect Ownership Interest | Jun 30, 2016 | 49% | |
| Operational/Managerial Control | Jun 30, 2016 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Chicago, IL
- NPI 1699828061
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662422400000",
"number": "1417962812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17W662 BUTTERFIELD RD STE 306",
"city": "OAKBROOK TERRACE",
"state": "IL",
"postal_code": "601814006",
"telephone_number": "847-565-4170",
"fax_number": "847-565-4173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17W662 BUTTERFIELD RD STE 306",
"city": "OAKBROOK TERRACE",
"state": "IL",
"postal_code": "601814006",
"telephone_number": "847-565-4170",
"fax_number": "847-565-4173"
}
],
"practiceLocations": [
{
"address_1": "830 E. Higgins Road",
"address_2": "Suite 115",
"address_purpose": "LOCATION",
"city": "Schaumburg",
"state": "IL",
"postal_code": "601734702",
"country_code": "US",
"telephone_number": "847-565-4170",
"fax_number": "847-565-4173",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "P.W. HOME HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-31",
"last_updated": "2022-09-06",
"certification_date": "2022-09-02",
"status": "A",
"authorized_official_last_name": "PONTE",
"authorized_official_first_name": "CARMEL",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "847-565-4170"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakbrook Terrace, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.